Just had my recent blood results and all are good with no action required. It’s been two and half years since my HA,Stent and followed by triple bypass and I have been on statins one type or another since then. Despite not having high cholesterol (currently 4.3) I have had increasingly painful legs especially through the night. Having my legs checked several times nothing could be found although one doctor suggested it could be the statins. I have a audio appointment next week with DR and I am going to ask that I stop taking Atorvastatin 40mg. Any one know of a reason why I should not give it a try
Statins: Just had my recent blood... - British Heart Fou...
Statins
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gilreid1
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Congratulations on the good blood test results.
Stopping statins might not be the best plan, they’re one of the reasons you’ve not had another heart attack. Maybe you could explore with your doctor reducing the dose or switching to another type?
Good luck!
Thanks for prompt reply. I am currently on the third type of statin and dose reduced every time. My thoughts are that prior to my HA my cholesterol was not high 4.8. The cardio at the time intimated that he would not have put me on statins as I showed no signs of concern? And my legs were fine 🤷♂️
in reply to gilreid1
Statins are not only prescribed to reduce cholesterol.They draw cholesterol out of plaque and stabilise it stopping "chunks" falling off and blocking your arteries and hence heart attacks.
gilreid1 in reply to
John. Yes aware of that is one of the benefits. But without high cholesterol the chance of plaque is reduced. And after my stent all was explained to me in great detail. The blocked arteries cause the HA. I think plaque falling of causes a stroke. Both equally as dangerous. But again John thanks for your input much appreciated
"The blocked arteries cause the HA"
Hello gilreid, I don't want to start a debate on such a beautiful sunny day, but I"m not sure I necessarily agree with that. It really depends on how we interpret those words.
When a plaque ruptures it often blocks the artery, and that causes the heart attack. But a plaque that grows without rupturing, slowly blocking an artery, well that cause angina not a heart attack.
Over half of all heart attacks occur in people who have very low levels of arterial blockage, sometimes virtually undetectable. Conversely there are plenty of people on this forum who have high levels of arterial blockage (stenosis), well over 90% in many cases, and suffer serious angina as a result, but have never had a heart attack.
The explanation for this conundrum is that there are two types of plaque.
Soft liquid plaque that's liable to rupture, and when the liquid contents spew out into the blood stream it immediately solidifies. In most cases it remains attached to the original plaque (in other words they don't generally break off and whizz around the blood stream), but as they solidify they can partially or fully block the artery and starve the heart muscle of oxygenated blood.
The second type is a harder, calcified, more stable type of plaque that is very unlikely to rupture. We all have a mixture of both types of plaque, but some of us tend to grow the soft type and others tend to grow more of the stable type.
Statins, especially when taken in conjunction with Ramipril, tends to turn soft plaque into stable plaque. That's why I regard statins, even though like you I also have low lipid levels, as a critical weapon in the armoury that will keep me fit and safe.
Anyhow, back to enjoying life in the sunshine!
Thank you for some really helpful information, 👏👏🤗
in reply to Chappychap
Thank you from me too for the info, I have non calcified plaque which I therefore think is the soft stuff Per your explanation which is more likely to rupture. Hope I got that right.
Thank you for the info, i never fully understood before as gp's don't usually tend to explain, ilkley just tell you that you have high cholesterol offer you status and that's it, at least you explained.
Thanks Chappychap that is very informative. Like gilreid1 I never had had cholesterol, lead a healthy lifestyle, ideal weight, ran three times a week and walked every day yet still ended up with a severely blocked LAD which was stented in 2020. Still don’t understand why it happened
Great response however 10% of heart attacks occur in people with no permanent blockages in their coronary arteries.
MINOCA myocardial infarction non obstructive coronary arteries.
The common causes, microvascular dysfunction, vasospastic angina, spontaneous coronary artery dissection SCAD, a blood clot or the break off of a small area of plaque.
Non obstructive coronary artery disease NOCAD also causes angina when the blood vessels in the heart do not work properly. Either they fall to dilate in response to extra demands or go into transient, temporary contrictions causing a lack of blood supply to the heart.
The awareness of angina non obstructive coronary arteries ANOCA has greatly increased in recent years.
Coronary vasospasms in particular can be associated with obstructive disease. The artery near the blockage or stent can go into spasm.
This group of patients are also precribed statins to help the lining of the blood vessels function better.
Also to help prevent obstructive coronary disease developing.
Brilliant reply as always. I always learn stuff from you!!All the very best. Jan xx
Hi gilreid1,
I agree with Chappychap I'm afraid, I was on statins for many years, and returned low cholesterol results as a result, but..... unfortunately not high enough, I had the heart attack, had the 7 stents, because even with the help my arteries were in a "shocking state" (Consultants words). I just have bad genes/plumbing/luck I guess, but without doubt I would have been in far greater mess far earlier without the statins.
Please persevere as we are the lucky ones on here, we're still here to be able to reassure each other. All the best.
Maybe I have worded my post incorrectly. I am certainly not anti statin in fact the opposite. What I am trying to fix is the pain I suffer in my legs. And after many checks it all points to a side affect of statin. I know the benefits but surely something other can be found. Hence I have volunteered to take part in clinical trails. Attached is my heart prior to stent
Angiogram
I take your point.
One last thought, given the usual provisos that I've no medical qualifications, if I ever concluded that the side effects of statins were so severe that they were preventing me from exercising or causing me to gain weight, in other words they were materially damaging my life style choices, then I'd explore with my doctor another option.
I have heard of GP's who have prescribed very, very low doses of statins, and only taken on a couple of days each week. In other words the patient and doctor have worked together to establish the maximum statin dose that the patient can tolerate. Apparently there are still statin benefits even with low doses, not as big benefits, but they don't completely vanish.
By the way, your heart chart looks very interesting, I've never seen anything like that!
Good luck with the medical trials!
Happy you have expressed my views exactly. I become very frustrated that I had a very active life and I am not stupid to think that a return to what I consider normal will be achieved. But all I have been thru let’s try to relieve a current problem. Example being I used to play golf four days a week. Now twice max. Not because of lack of energy but pain in my legs is unbearable.
Hi gilread, I had the same problem with atorvastatin, awful pain in my legs, specialist reduced my dose to 5mg every other day and it reduced my cholesterol so we’ve decided to up it to 5mg every day, cholestorol is still dropping and no painful legs x
Oh, and they changed the statin to rosuvastatin x
I’m on Rosuvastatin 5mg a day too. My cholesterol prior to lock down had always been low but too much cake and staying in doors sent my level rocketing. I haven’t had any pains in my legs. I stopped the regular cake afternoons and it’s now back to under 5. I’m still taking it as apparently the benefits of a statin are widespread. Have you tried this statin Gilreid1?
in reply to gilreid1
Hi and good morning. I’ve been reading your posts and the replies with interest. In most of our cases the statins are essential however I had dreadful side effects from firstly Atorvastatin 80mg … and after talking to my new GP stopped them briefly to clear my system as best we could to then try several different ones. Swollen legs and unable to walk or sleep due to the pain … so they don’t work for everybody sadly. Have a word with your GP as these side effects are real. He May reduce your dose right down to minimum. Having said all that you are definitely better taking some form of statin as a precaution. Because my cholesterol is high and is inherited through family I was put on the injection once a fortnight and I’ve never felt better. A wee chat with your GP will soon sort stuff out … take care
I've taken 20mg of Simvastatin per day for 19 years. During that time, leg pain has been present at night and particularly severe in the last few weeks. If you are retired then having only four or five hours of sleep is OK as there is time to make it up: Otherwise, it is best to go for an alternative.
A warning though I've no idea if stopping statins has anything to do with it. A neighbour stopped taking his statins mainly doing some self-medication that many did during the covid period when getting advice is difficult. He did suffer leg pains. He had a heart attack in February and died on Sunday after suffering a severe brain hemorrhage. So the warning is to NOT self-medicate.
Here are seven alternatives from the British Heart Foundation:
Hi due to side effects of statins, including a lot of pain in legs, I have been taking Ezetimibe with no side effects, something to suggest to your GP I think?
Sounds familiar. I understand the good work statins do but like exercising. Walking my dog 🐶 playing golf and just out and about. Right now I am sitting after playing golf and need to move about every fifteen minutes or so to relieve the pain. When walking no pain ?
I have been on 80mg Statin since my HA 2.5 yrs ago my cholesterol was only 4.8 before the HA and is now around 2.7. I asked the same question to the cardiologist and was told a definite NO. He said I was never on them to lower cholesterol, but they help prevent anymore HA happening.
Oh I like this answer. What I can’t understand is that I have met many people who consider Statins the green light and really think they can indulge . I was taken off Statins because I felt sick and had persistent diarrhoea so I don’t take them. I had no life therefore. Now I watch my diet , exercise a lot and hope for the best. My sister had an awful time on them with muscular pains but she kept on them with the result that she put on weight
Hi, I stopped for the same reason along with other pains. However after two weeks my cholesterol shot up to 6.7. I'm now on 20mg a day and find it much better. Ask for it to be reduced for a month and see how you go.
So sorry you cannot return to the lifestyle you previously enjoyed.It’s accepting that after the health problems you had you might not be able to get back to the same level of activity.The pains in your legs does need addressing with a specialist for you to be able to go forward comfortably on your statin.They usually change the statin your on but you have already tried this .
Hopefully you get a solution soon but the risk of further heart problems are the reason you are on statins.
I am on the same statin with some discomfort but have finally accepted the statin is helping me live longer.
I really don’t expect to have the same quality of life as previously but really want to have some pain relief and maybe the odd nights sleep for more than three hours 🫰
in reply to gilreid1
Totally get that. As per my previous comment. Quality of life is essential
Ask your doctor whether there is a role to play here for Ezetimibe. It is complementary to statin and takes cholesterol out of the stomach rather than out of the (? can't remember where the literature differentiating it said that regular statins draw cholesterol from?).
My research, when my latest local cardio proposed it, indicated that a combination of regular statin and Ezetimibe is a relatively new and effective way of controlling cholesterol levels and at the same time reducing the impact of regular statin side effects. I've not yet had my lipids tested since changing my drug cocktail, but the literature on trails of ezetimibe is quite persuasive on this score.
After my triple bypass 3 years ago my Bangkok operation cardio and surgeon settled on 20mg of atorvastin/ 5mg bisoprolol/75mg clopidogrel and 81mg aspirin. After 2 years of good results I persuaded the cardio to let me drop to 10/2.5/37.5/81 and my results stayed at the very acceptable (in his words) level.
Then 6 months ago I had a day when my very infrequent and short-lived 'heart murmurs' turned into a day of 4 relatively short but heavily pounding taccychardias, one presenting with breathlessness and dizziness. One night in ICU at a local hospital with constant EKG and a couple of ECGs apparently told the cardiologist there nothing useful and he admitted he was assuming I had potentially had an AFib event. So he released me with an additional 250mg a day of amiodorone. I didn't get on with the amiodorone at all and the specialist had done little to check for conflicts it might have with other heart and lung meds I was taking and nothing to explain the potential side effects of this pretty toxic new-to-me drug.
So I looked for another private hospital and cardio local to where I live (in the agricultural outback of Isaan). He did not disagree with the punt at AFib but in the light of my bad experience with amiodorone he went down the track of dropping it away and increasing dosage of two of my four initial heart meds so I was now on 40mg atorvastatin/5mg bisopro'/37.5 clopidog'/81 aspirin.
My side effects of joint pains (enhancing the misery of osteoarthritic hips and an increasingly intolerable lower back pain), made me exhausted in the second half of the day and I was losing loads of sleep. After 3 weeks I appealed for another plan. He punted that the dive down was most likely driven by 40mg of atorvastatin and replaced it with 10mg atovastatin and 10mg ezetimibe. The pain, exhaustion and sleeplessness improved significantly and quickly. Back pains remained but a steroid injection against a malperforming vertebrae by a Bangkok spine specialist worked wonders on that.
I would be interested to hear if any of the Brits on here have tried Ezetimibe and whether it helped. I'm a Brit living in Thailand and normally using Thailand's best private hospital (in Bangkok). The one thing I would point out is that ezetimibe is relatively expensive here even in discount pharmacies when compared with atorvastatin (but the latter is dirt cheap anyway: western branded ezetimibe works out about 65p a day for a 10mg pill here - 3 times that of same brand atorvaststin 40mg cut 4 ways). NHS doctors may perhaps be encouraged to stay with the cheaper approach.
in reply to santisuk
My comment won’t help much as we’re all different but my cardiologist put me on 80mg Atorvastatin and…around 8 weeks later without seeing me got his secretary to call me to say he was prescribing 10mg of Ezitimibe to take alongside Atorvastatin …. I was pretty ill after a week of using them. Not for everybody.
I can sympathize. I definitely feel that I've had some unpleasant side effects from statins, but it sounds like they are reducing your Q of L significantly. I'd think your cardiologist would green light a "time out" to see if the pain in your legs goes away.
You have received lots of good advice about the positive value of taking statins - and not only for lowering cholesterol. But you are having some side effects that are clearly affecting your quality of life - so it feels worth doing something to see if the side effects can be improved. I'm a biochemist (with triple bypass and experience of statins) and, like most scientists, I like an experiment. In your position, I would try stopping the statins for a short time (maybe a couple of months) to see whether it improves your painful legs. You would, of course, do this only after discussing with your GP. If the legs improve, then you have learnt something useful. Personally, I would do everything possible to get back onto a statin - even at a low dose - after the experiment. Maybe a low dose of statin plus ezetimibe will do the job for you. Ezetimibe works in a different way to lower cholesterol and it seems to be little prescribed by GPs.
Hi - I was prescribed simvastatin many years ago and muscle pain for to the point I stopped taking it (stupidly without consulting the doc) Pain went away but some years later I had a HA. I was back on statins (for about a year before) but atorvastatin - originally I was on 20mg and had no muscle issues at all but this was upped to 80mg and unfortunately the pain started to increase and is getting to the point that it’s starting to effect daily life. As others have said statins also are reported to have a stabilising effect on the plaque so this time I’ll be consulting the doc to look at what it means to either reduce or look at another statin - all aboutpros vs cons - hope you get some good advice
Currently on 80 mg Atorvastatin suffered a few early probs with aches and pains now 2 years on have started taking it with my evening meal rather than 10 pm all overnight problems disappeared.Best of luck
I have found nothing that says ezetimibe stabilises plaque like statins. That's why ezetimibe plus a statin is best. This combination is the NICE recommendation for people who cannot tolerate a high statin dose but still have high cholesterol levels.
Correct.
My GP, when first prescribing statins, suggested as Mart25 suggests above. She said should there be any apparent side effects, stopping the statins for an agreed period to see if there was an improvement, then restarting to see if the problem returns, would show that there was a link.
I haven’t had any issues -I do have age related aches but I’m presently off the statins temporarily while a totally different issue is being sorted (to avoid med interaction and impact on liver) and have felt no different.
If you can ask for some help to be safely experimental, you may be able to find the type/dosage you can tolerate without problems whilst keeping the benefits of the meds.
I suppose much depends on having an approachable GP who will work with you.
I had the same problem as you have. Atorvastatin, Pravastatin and Simvastatin all similarly giving me leg pains. I was then prescribed Ezetimibe. Blood tests revealed that for me it had no effect. Eventually I was prescribed 10mg Rosuvastatin on alternate days. It initially gave me a headache, so I split the pill in two and tried it. After a week or so I was on the prescribed dose. Two years later my cholesterol was up to 4.0, so I asked my GP if I could take it every day and that's where I'm at. Baseline cholesterol 4.4, currently 3.7. No side effects.
Big thanks to all who replied to my post. I have a lot to discuss with my GP next week. Here’s hoping I get some positive result
My husband been the same with statins ha last April by pass in November 2021 they have put him on a 6 month break / holiday they call it from statins, his ck levels went through the roof the statins raise ur ck levels hence cramp in legs, they can give u different ones or reduce the statins to 20 mg which is what my husband went on before bypass he was fine but for some reason the want him on 40
I have a low cholesterol measure of 2.8, on 40mg Atorvastatin for 13 weeks now following a stroke. Maybe if I had been on a low dose statin following some heart investigations 6 years ago I might not have had the stroke- who knows. I talked to my GP yesterday, following monitoring bloods and asked the question about a lower dose. But he said it's a middle of the road option, keep going. I can't advise re your symptoms, but as these are recent and you have been taking statins for some time, it might be something else. But it's much warmer now, what about general hydration levels?
From memory very low I think the figures were 1.1 1.4 but much lower than the thresholds. I guess they should add up to the 2.8 but I think the Doctor bis trained to understand that stuff, as the Consultant said, 'where is your cholesterol?' and gave the initial prescription!
I can’t take statins as I have peripheral nerve damage as a result of chemo and this got noticeably worse on statins . I’m currently on ezetimibe and Repatha. This has been done by the hospital as I have very high lipoprotein (a) which is a risk factor for HA and strokes. GPs can’t prescribe Repatha - it can only be done through the hospital I regard myself as lucky my GP referred me to the lipid clinic when I was initially diagnosed with angina. I had a 100% blocked RCA and now have stents. Lipoprotein (a)can’t currently be treated so everything else has to be addressed - exercise, weight, smoking, diabetes risk and LDL. so that’s what I’m doing. Not sure it helps you much though
Your post is the first that I've seen on the forum that has mentioned Lp(a). I was tested for this and thankfully my level is within expected parameters. It was my Homocysteine level that was high and I now take Vitamin B for this. Unfortunately neither Lp(a) nor Homocysteine are understood by any of the doctors in my GP practice and I have difficulty getting regular checks, so like you it is down to exercise and diet... and a guess at how much Vitamin B I need.
In the U.K. they don’t recheck for lipoprotein (a) as it’s believed to fairly fixed. I was tested by the lipid clinic and I’ve been under them for two years stabilising my cholesterol and getting out of the prediabetic phase. I’m now discharged for two years on Repatha and ezetimibe. Elevated Lipoprotein (a) affects 20% of the population but not everyone gets any effects from it and some people get terrible effects. It’s still very under researched and I certainly wouldn’t expect a GP (GENERAL practitioner remember) to understand such a specific and still largely unknown issue. That’s why we have specialists. The only thing is my cardiologist wasn’t interested and said that it was the domain of the lipidologist and geneticist.
I was referred by the cardiology department in the local hospital to their pathology department where the tests for Lp(a) and Homocysteine were carried out. A full report on the findings was issued by the Pathologist to the GP. Yes, I agree that GPs don't know about these issues, but mine couldn't even reference the report to my health record. So whenever I raise a question about Homocysteine, no-one at the practice even knows I have an elevated level and of course taking Vitamin B for it isn't flagged up as it's not a prescribed medication.
The last Homocysteine blood test I managed to have was last year when it was found that the level had crept back up above normal range. I asked for a check on it this year and was refused. The only response I got was that I was taking Vitamin B and that was all I needed to do. Yes... but how much Vitamin B? Was the level stable or going up still? With the absence of any further tests all I've been able to do is to increase my intake to two tablets a day and hope for the best.
Ha ha ,you gave me so much grief saying I'm scare mongering and your not a doctor..... I have no problems with my medications etc etc now your saying same thing I was saying and daring to think for yourself ! stupid man
I actually got some benefit (which made all the difference in terms of being able to continue) from taking rosuvastatin 5mg twice daily rather than 10mg once daily. Maybe worth trying something similar (I'd already been on others I couldn't tolerate).
Looking back over two years I can remember a cardiologist, looking at me before my bypass , very sternly and said that I must be able to tolerate Aspirin. He never mentioned statins🙀
HiMy heart attack last year was caused by plaque breaking off and blood clot which caused 100% blockage in my LAD. When my cholesterol was checked at the time it was 3.5 which is very good. After a year on statins its now 2.5 which is perfect(the good and bad levels are perfect too). My point is that its not just high cholesterol that causes plaque,in my case heart disease seems to be heriditary. Consultant said at time that there are a few other arteries with slight narrowing(plaque build up) and the statins keep this stable and hopefully prevent another heart attack from which i might not survive so i am more than happy to keep taking the tablets😊
Hi, My condition is very similar to yours, HA last year out of the blue at 47. A STEMI, guess hereditary. If you don’t mind me asking whats your current Statin dosage?
The question was about pain in the legs. And the causes of that could be tough to tease out. I had an MI caused by blockage at way to young an age. I was fit, health conscious etc etc. Took atorvaststin, a beta blocker, baby aspirin after MI. Had been taking statin and BP med prior.
Over the years I developed incredible aches in my legs mostly. Very stiff. To the point that picking something off the floor was an ordeal…something to avoid. Spent time each morning just stretching to loosen things up a bit.
What helped was changing statin and lowering dosage. But what was life changing was realizing I was a little low on my Vit D levels. A daily supplement has improved my aches by 75-80% I’d estimate.
Did your bloods include muscle enzyme check? I ask as I was suffering debilitating leg cramps after a few years on atorvastatin. Which stopped within a week of stopping the statin.
Compelling evidence from the majority of the studies reviewed shows that statins exhibit a protective effect against the occurrence of ventricular arrhythmias and atrial fibrillation.
After my triple CABG and AVR I was on 80mg Atorvastatin and 400mg Bezalip and I suffered dreadful pain in my legs. This was subsequently reduced to 40mg and the pain ceased. The Bezalip was replaced withEzetimibe 10mg recently.
Thanks for your reply 👌
Thank you for the link to this article, interesting!
When I had aching legs on statins after a heart attack, my GP stopped them for a month to get them right out of my system before he could tell if they were the cause. They were not. I'm back on them and still have aching legs. Make sure you have GP permission. YOu say you've tried several. It's unlikely they all caused the same problem. Remember you tend to only see bad reports online. Those who take them without problems generally don't say so. There's a great video on part of the BHF website where consultants discuss just this apparent problem. I think the section is called something like "Live and TIcking". Can anyone find the video?
I have familial hyperlipidemia..meaning hereditary high cholesterol.I was prescribed 40mg of Lescol.
A few years later, the pain in my legs became unbearable.
I had trouble walking.
My Dr. took me off Lescol, and told me not to take statins again.
At 57, I had a MI, that required 3 stents.
I was prescribed 40mg of Pravastatin, and 10mg of Ezetimebe.
I refused 40mg of Pravastatin, and now take 20 mg of Pravastatin.
I tried Ezetimibe for a period of time, and then stopped that too. It was making my pain worse. Ezetimibe does not increase mortality, it lowers cholesterol.
I was then prescribed Repatha, an injectible drug, along with the Pravastatin.
The Repatha caused so much pain, that I would be bedridden for 2 days after the injection.
The 20mg of Pravastatin causes significant pain. I take it at night, before bed, and sleep through some of the pain, thankfully.
While I should be on higher doses of statins, and other drugs, my quality of life suffers so badly that my Dr.'s and I have decided that the 20mg of Pravastatin, and higher end cholesterol numbers, are the best option for me.
I had such leg pains from 3 different statins, I've been classified allergic to them. I was switched to Repatha sure clic (like epi pen) and cholesterol is perfect. As with most advice here? I would talk to dpctor before starting or stopping any meds....
Everyone in my family has/had cholesterol problems....we dont eat meat more than once a week, drink fat free milk and rarely have butter....repatha is a great med!
Thanks for advice 👍
Hi are you taking vitamin D ? My nephew is taking statins following a TIA and also experienced muscle weakness and pain. A fellow sufferer suggested he try a vitamin D supplement and within a few days he got relief. I've checked with DR Google and there are a few articles relating to this solution but check it out with your doctor first. I am also on statins and take Vitamin D, as advised by the DR and have not issues.
Good Luck
Was taking 80, I dropped it to 40, but now I'm going to 3 days a week 40, other 20mg joints becoming stiff my tric levels still high but I eat a lot of nuts,I'm considering plant sterols soon
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